Atypical optic neuritis as the presenting feature of testicular malignancy: Rare case report with review of literature

A 23-year-old male presented with unilateral acute onset, painless, progressive diminution of vision. Initial clinical and radiological findings were consistent with optic neuritis. The patient was started on pulse steroids leading to visual recovery. However, the patient relapsed within one week. Repeat imaging revealed metastatic lesions near the orbital apex. Orbit is an unusual site of metastasis from testicular tumors and only 3 cases of testicular synovial sarcoma with orbital metastasis have been reported. A thorough systemic evaluation should be done in cases of atypical and relapsing optic neuritis to rule out the causes of optic neuritis (ON) masquerade syndrome.